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Zusammenfassung Im vorliegenden Text beschreiben die Autoren die erwünschte und unerwünschte Wirkung von Neuroleptika in Bezug auf deren Reduktion. Der Verlauf der Genesung von Psychosen wird beleuchtet vor dem Hintergrund der Reduktion von Neuroleptika und wie diese Prozesse individuell und dynamisch miteinander in Verbindung stehen. [ABSTRACT FROM AUTHOR]

Copyright of Sozialpsychiatrische Informationen is the property of Psychiatrie Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sozialpsychiatrische Informationen is the property of Psychiatrie Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

During recovery from psychosis (diagnosed as schizophrenia) things must often be done slower than normally expected. The tempo of the socially shared reality is often experienced as being too fast for the recovering person. We will describe how this impairment stems from the pre-reflective mental structure underlying psychosis and how it can be transferred into an active skill supporting recovery, often including social retreat. In this paper, co-written by a psychiatrist and a person experienced in psychosis (= participatory health research), we will draw on personal experiences, (participatory) qualitative research and first-hand accounts for our arguments. We will sketch out the process and three crucial building blocks of recovery: laid-back situations, switch-off skills, places to talk. We will then describe the acquired skill of slowing-down as an amalgam of the building blocks 'switch-off skill' and 'laid-back situation', since slowing-down answers the situation in a laid-back manner and enforces a slow behavioral pace on it. While this might be okay in private and in some situations shared with others (i.e. during serene situations), it may be tantalizing for others in many everyday situations resulting in stigma or exclusion (i.e. during work). Slowing-down therefore challenges the surrounding others and demonstrates the necessity to synchronize private and public tempos. This is most challenging while living in two realities at once, being the second and often a long-lasting stage of recovery (stage of double realities). [ABSTRACT FROM AUTHOR]

In diesem Beitrag versuchen wir aus ambulanter und stationärer Perspektive, teilweise auch mit gegensätzlichen Positionen, dennoch ein möglichst vollständiges Bild unserer Erlebnisse und unserer Erfahrungen mit den Veränderungen durch die COVID-19-Pandemie in Psychiatrie und Psychotherapie wiederzugeben. Aufgrund gemeinsamer Überzeugungen zur Verbindung von Psychiatrie und Sozialpsychiatrie und jahrelanger fruchtbarer, manchmal auch kontroverser, Zusammenarbeit formulieren wir diesen Text aus unterschiedlicher Perspektive, dennoch in der »Wir- Form«. Es gibt durchaus Widersprüche zwischen der ambulanten und der stationären Betrachtung der Psychiatrie. Was uns jedoch verbindet ist die Grundhaltung. [ABSTRACT FROM AUTHOR]

Copyright of Sozialpsychiatrische Informationen is the property of Psychiatrie Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Understanding the mental life of persons with psychosis/schizophrenia has been the crucial challenge of psychiatry since its origins, both for scientific models as well as for every therapeutic encounter between persons with and without psychosis/schizophrenia. Nonetheless, a preliminary understanding is always the first step of phenomenological as well as other qualitative research methods addressing persons with psychotic experiences in their life-world. In contrast to Rashed's assertions, in order to achieve such understanding, phenomenological psychopathologists need not necessarily adopt the transcendental-phenomenological attitude, which, however, is often required if performing phenomenological philosophy. Additionally, in the course of these (non-philosophical) scientific endeavors, differences between persons with psychosis/schizophrenia and so-called normal people seem to have a methodological function and value driving the scientist in her enterprise. Yet, these differences do not extend to ethical dimensions, and therefore, do not by any means touch ethical equality. [ABSTRACT FROM AUTHOR]

In this paper the question of autonomy in delusional disorders is investigated using a phenomenological approach. I refer to the distinction between freedom of intentional action, and freedom of the will, and develop phenomenological descriptions of lived autonomy, taking into account the distinction between a pre-reflective and a reflective type. Drawing on a case report, I deliver finely-grained phenomenological descriptions of lived autonomy and experienced self-determination when acting on delusions. This analysis seeks to demonstrate that a person with delusions can be described as responsible for her behaviour on a 'framed' level (level of freedom of intentional action), even though she is not autonomous on a higher ('framing') level (level of freedom of the will), if, and only if, the goods of agency for herself and others are respected. In these cases the person with delusions is very nearly comparable to people in love, who are also not free to choose their convictions, and who could also be rightly held responsible for the behaviour flowing from their convictions. [ABSTRACT FROM AUTHOR]

In this article, we present two accounts of intersubjectivity in Jaspers and Husserl, respectively. We argue that both can be brought together for a more satisfying account of empathy and communication in the context of psychiatric praxis. But while we restrict ourselves for the most part to this praxis, we also indicate the larger agenda that drives Jaspers and Husserl, despite all disagreement. Here we spell out, in particular, how a phenomenologically inspired account of empathy and intersubjectivity can have larger ramifications for a theory of social life and interaction. Finally, we argue for a 'relaxed' view concerning the relation between pure and applied phenomenology, such that both can mutually benefit from one another. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In this paper Karl Jaspers' writings on psychotherapy and the psychiatric practice will be profoundly investigated and a meticulous reconstruction of the development of his understandings in the course of his oeuvre will be presented. This reconstruction allows for arguing that Jaspers displays a methodologically critical attitude towards medicine as a 'science of actions' and that he did refrain from developing an existential psychotherapy for methodological and existential reasons. Nonetheless and aside from Jaspers' abstention, some of his concepts from existential philosophy, like 'Grenzsituation' (border-situation, limit-situation) or 'Gehäuse' (shell, housings), can be extraordinarily fruitful in psychotherapy and in the psychiatric practice because it requires a change of attitude in order to bring these concepts into play. This different attitude could be called the attitude of the fellow sufferer, or, more neutral, the attitude of the fellow human being. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Phenomenological descriptions of depressed mental life offer a profound understanding of depression from the first-person perspective. In this paper, such descriptions are developed by drawing on the work by Ludwig Binswanger (1881-1966) and on the autobiographical report of depression by Piet C. Kuiper (1919-2002). I will argue that Binswanger's central claim in his phenomenological description of the depressed state of mind fails due to crucial misunderstandings of Edmund Hus-serl's (1859-1938) phenomenology. Nonetheless, by drawing on Kuiper's first-hand account, I will develop a phenomenological description of depressed mental life, highlighting the altered manner of pre-reflective valuing in depression and introducing the concept of a 'depressive habituality.' This term refers to the acquisition of a new set of habitualisations, especially on the foundational levels of automatic mental life. It offers explanations for the fact that it is not easy to recover from depression and that people may more easily become depressed again. [ABSTRACT FROM AUTHOR]

We offer here a framework for the understanding of being in recovery from schizophrenia as an interpersonal process. We draw upon in-depth phenomenological descriptions of the fundamental changes taking place in an individual's mental life when they are suffering from schizophrenia. There is a loss of commonsensical habituality and interpersonal capabilities, usually most prominently expressed as an impaired intersubjective resonance. People with schizophrenia cannot as easily automatically and coherently display their own emotion via their facial expressions or perceive those of others, as do 'normal' people. This implies that interpersonal resonance between interacting individuals is not automatic, as is often taken for granted. The need to actively rebuild interpersonal resonance also holds true for the interacting 'normal' person, but would be an unfamiliar and unexpected task. These difficulties in empathizing provoke a mismatch in interpersonal resonance, often leading to the intuition that the person having schizophrenia lacks (explicit) self-awareness. We conclude that there is a mismatch in the form and scope of the social cover extended to the social role opportunities available in trans-Atlantic cultural settings for people with schizophrenia. Typically, these social roles imply that people with schizophrenia are unaware of themselves; however, while they often lack insight or may not consider their symptoms as signs of a mental disorder, they are usually not 'confused' or 'distracted' in the sense of no longer being aware of themselves. We discuss various options for adequate social cover achievable for people with schizophrenia, demonstrating their impact on the recovery process. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

In this article, I focus on possibly impaired self-determination in addiction. After some methodological reflections, I introduce a phenomenological description of the experience of being self-determined. I argue that being self-determined implies effectivity of agency regarding three different behavioural domains. Such self-referential agency shall be called ‘self-effectivity’ in this article. In a second step, I will use this phenomenological description to understand the impairments of self-determination in addiction. While addiction does not necessarily imply a basic lack of control over one’s life, this can well be the case during certain periods of time or in special situations. Addiction is herein described as an embodied custom—highly effective with respect to changing one’s lived experience—which is learned and developed while becoming addicted. Such a repeatedly performed custom, called a ‘psychotropic technique’, implies deep changes in one’s personal identity and alters an agent’s ‘self-effectivity’. In the closing section, I discuss the possible implications of a phenomenological approach to personal responsibility. [ABSTRACT FROM AUTHOR]

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between "natural" and a "reflective" experience built into phenomenological method itself. Drawing on the works of phenomenologically oriented thinkers, we describe life as inherently "teleological" without collapsing life with our subjective perspective, or stepping over our epistemological limits. From the phenomenology it can be demonstrated that the hypothetical teleological qualities are a reflective reconstruction modelled on human behavioural structure. [ABSTRACT FROM AUTHOR]

The authors convey their concerns about a report regarding antidepressant withdrawal and rebound phenomena. Topics mentioned include the absence of sustained substance use in spite of confirmed unequivocally harmful sequelae, the challenge of tapering off antidepressant treatment, and the suspicion of long-term medication harms concerning the course of depressive moods.

In this paper the question of autonomy in delusional disorders is investigated using a phenomenological approach. I refer to the distinction between freedom of intentional action, and freedom of the will, and develop phenomenological descriptions of lived autonomy, taking into account the distinction between a pre-reflective and a reflective type. Drawing on a case report, I deliver finely-grained phenomenological descriptions of lived autonomy and experienced self-determination when acting on delusions. This analysis seeks to demonstrate that a person with delusions can be described as responsible for her behaviour on a 'framed' level (level of freedom of intentional action), even though she is not autonomous on a higher ('framing') level (level of freedom of the will), if, and only if, the goods of agency for herself and others are respected. In these cases the person with delusions is very nearly comparable to people in love, who are also not free to choose their convictions, and who could also be rightly held responsible for the behaviour flowing from their convictions. [ABSTRACT FROM AUTHOR]

In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical. [ABSTRACT FROM AUTHOR]